02040018 (2) CI BUILDC PERTNO
DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
7933 RAINBOW DR JUST WATER HEATERS INC 02040018
OWNER'S NAME: APPLICATION SUB DATE
LUCIANO SACCANI 1764 NATIONAL AVE 04/03/2002
PHONE: (510) 293-9901 SANITARY NO. CONTROL NO.
'
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
w BLDG ELECT PLUMB MECH
�< L
LICENSED CONTRACTOR'S DECLARATION
1 heren form that I am licensed under p g Job Description
j 2 m C y a pod Pions of Chapter and
(commencing
hint is inoftforevolei°nlnrmeBusinessanarranss:anset�Je.anamyrceae REPLACE WATER HEATER.
L m loll,lass effect.
(5 0 GALLON GAS)
a s< License Class Lis.N
iORU Date Convector
Et O G ARCHITECT'S DECLARATION
1 tmderaru,d my plans shell he used as public records
Y
7 a.p OLimned Pnifeesi...I
m that I a exempt r DECLARATION
W v, I hereby affirm that I am.exempt from the Contractor Cod :Any c ty o for the
my
C < following reason,permit
in
7cosma Business..11, and Professions Code:Any city or county
O which requires n permit m cams t e6 ulmc nt]m Such
demolish,or rcpan any structure
o.3= .priormits¢suanee.elmrequircs thenpplicamfor such perminofileosignm smtnnem - - _.____
Nit heisJicetrud Wrsulnf mthe pl.visiuns of Ne Conuanoh Licenu Law(CM1apmr9 _ S Ft.Floor-Area- > Valuation
with Sectionl]0011 (Division lof Ne Businex ml Profs ons Code) ` s f , 1 1
(<omme�emg,, )a syr E'�):�, ?A '.r- f lois• .�= tt,\..:Cs(
or that be is eaempi Nefefrom'.and the basis for the alleged aemgtiod.Ty violation
-of Section 7031.5 by any applicant for a permit subjects the applicant to a civil Penalty
Iofnanm,re than euehundred dollars ls5txl), umber :",:t.'rfr:. Occupancy Type
❑Las owner of Ne propirt,ser my employees with wages as their talc compensation.
will dothework,and the structure isnot intended or offeredforsale(See:)Uta,
tsusmc.s'andProfessions Come:The Contractor'.License Law does not apply toan 506 — GAS TESTzequiredInspections
r of property Who builds or improves thereon,dad who does such work himself t
lune
507 — FINAL PLUMBING
11.....ipl,his we c»pl.yeespmmJal_hat such improvements am nor intended or
nRct9A
)-71,_.__._.__. . ..
completion.the owner-Wilder wiII have the burden f proving that he did not Wild or �' •t
improve for purpose of salej, C'A p p O E®-_-
___.. __ - _.— ._.__.__.. _.._...._- C�G s�1 Fa
❑L nx owner ar me prepeny,an,«elusively cammc(mg who rmnaa°ommemrs to ...... .__.. . ... ._.._.... _
License the project(Sup.]to a Business andpre emfcssiob Cwlep The vented neon, , ,
and wh Law does net apply to otj owner of ,cony who)ilds ficempe improves thereon, -'
_ami who.c.ntncm.far such projens.wiN.a.contracwr(s)limrtud.pursuant m.Ne. 5._.2002_.-_-: ._..- _-. _-------...--------,._-- ..
_ - C ntmcmr s License Law.
❑Ism eumpt under S<c.' .B'&PC fortis m � P
.. .. :
:. -.: Owner' Dole . rea . BUILDING
WORKER'S COMPENSATION DECLARATION
I hemby efhren ands,pctelty of perjury one of the following declaetion:
❑ 1 have and v.'ill maintain a Cenificate of Consent to sdf-ir,ms,for Worker's
Compensation, as provided for by Section 37W of the Labor Code, for the
Performance of the work for which this Permit is issued.
❑1 have and will maintain Worker's Compenchion•Insurance,as required by Section
37W of he Labor Cole,for the peiformance'6d the work I.,which this permit is
5 issued.My Worker',Cnnp Ynl .urance comer and Policy rttmber are '
Carts t'Y n 'L' :.-PatiyN° :_ "
CERTIFICATION OF EXEMPTION FROM WORKERISt ., t ;{•4YeR's Y\ (. [tit� l• r, \' •
,st COMPPNSATIONINSURANCE
(Th s.Caton need net be can,pletcd if the permit is for one hundred dollars
[g1W)orless),. ,
-'-"rl'reni(y than in thgperformance 6f thb work for which this permit is izweda - - -- - - s" t„ i.. , ., _...,...�..
;hall not employ any person in any manna m be
as t. come subject t°the Workers' '" '' "'• "'
Comldnsbainn Lawn al'Calih�mia.Dute.: l
-Applicant .. _.-..-_ ..._ _ ..
NOTICE TO APPLICANT:IE after making his cj,i.swmflh Labmi.my.uWnres, - •. :
heroineh com t.the such
Compcnathis pr.vi.i sheaf she Loner Coda you nun
s
0 mild
0 fon-- comply with such provisions or this permit shall be dtt I looked.
F in •t '!' T.''. CONSTRUCDONLENDING'AGENCY'• ° .._ •.' .. r ..
• '"'I hereby afhmro
i that there is a csm,ction lending'agency'for the performance
of the work for which this, mu Is issued(Sec,309],CivC.1.
"Lender's Name. •soor_ .. ,•.._._ . ... .......:.... .._..,.i..:.. G.. ... .. ... ... ... _ ..._ _ ... _.___ ._.__.___.__ ._ _ ...
L.7 � I cagey that I have mod anis city anation and etmcanc the above maws refining is �✓�---
fa U rebuilt:1 agree m comply with all city and county ordinances and nate laws eluting
: 0:(",) the aildingcontrued propaid hercnyemefionrfprtscnmtiJcs of thiscirytocnerupon
the above-mentioned progeny for inspersion purpom'x.,_ ,
} VI ts.judgmets.cost and
which
in an wayaemeninoegoinn
liabilities judgments,costs end expenses which may in any way acerae against raid
- C.)eZ APPLIcANTU DEWSnegmmiA Dthis permit.
'< :'� APPLICANT UNDERSTANDS AND WILL COMPLYWITH'ALL NONcPO1fiT' Issuedb r Date
SOURCE REGULATIONS. 't Y'
Signature ofwpplimitlCormactnr' " "'i t r; -:Date •.., Re-roofs
HAZARDOUS MATERIALS DISCLOSURE
w"b he rp,Ii,.ou iii,future bIding oc up rt vore or handle hdo s material Type of Roof.. ... .... .: _. . .
is d f ed by the Cupen p M c p 1 Code.Chapter 9.12,and the Health and Safety
Code Section 255320.) ' t sIt
L• '; j•i - .
ore," - No P% t' r ,k _ All,roofs.shall be,ins ected prior to any roofing material being Installed.
d Will he ppfiema 0,future building color mccgttpmem or device,which If a roof is installed'without first obtaining an inspection,rl agree.to remove
mu M1 and 'nem t as defined by the Bay Area Air Quality Management
emit r all new materials for inspection. Applicant understands and will comply with.
ares - C]No , , all non-point source regulations. .;_ t -
I Wee read the hazed 'mamtials ociptifirements under Chapter S. 5'of the
Califomia Health&Safety Code:Sections 25505;25533 and 25534.1 understand that
ifitie hnildin Jun not current) have a enam,that it is 'bilis to evil( ,he -
g r my r y
_ °cctipem of the requirements which mus;W met prior to issuance°f 5 CeriiGcam of
s]ccupency. ::.., .,
=: -=. ' ..•' - ._'•. :. -....J,_. Signature of Applicant _ - ---D-ate
All roof coverings to be Class"B"or better
Owner or Womm,ed agent i - '? Date
n s . .
' s :n'. � - - '- OFFICE' "